[Histopathological distribution characteristics and prognostic value of cancer-associated fibroblasts in non-small cell lung cancer].

To investigate the expression differences of smooth muscle actin (SMA)-positive cancer-associated fibroblasts (CAF) in different regions of lung squamous carcinoma and lung adenocarcinoma, as well as to analyze their prognostic value. Data of a total of 243 non-small cell lung cancer patients who underwent radical surgery from January 1, 2014 to December 31, 2018 at Shandong Cancer Hospital were retrospectively collected. Tissue microarrays containing the tumor center (TC) and invasive margin (IM) regions were constructed using patients' postoperative paraffin specimens, and the densities of SMA CAF within the total, epithelial, and stromal regions were detected using multiplex immunofluorescence. The recurrence-free survival time (RFS) of patients was obtained by the electronic case system or telephone follow-up, and univariate and multivariate Cox regression analyses were used to clarify the factors influencing the postoperative recurrence of patients. Of the 243 patients, there were 83 cases of lung squamous carcinoma, with 30 (36.1%) recurrences during the follow-up period, and 160 cases of lung adenocarcinoma, with 46 (28.8%) recurrences during the follow-up period. In the TC and IM regions, the differences between the lung squamous carcinoma group and the lung adenocarcinoma group in total, epithelial, and stromal SMA CAF were not statistically significant (all ＞0.05). Multifactorial Cox regression analysis showed that IM SMA CAF/TC SMA CAF was an independent risk factor for RFS in patients with lung squamous carcinoma (=2.833, 95% : 1.187-6.671, =0.019), and adjuvant chemotherapy was an independent risk factor for RFS in patients with lung adenocarcinoma (=2.682, 95% : 1.178-6.006, =0.019). There was no difference in the spatial distribution of SMA CAF between lung squamous carcinoma and lung adenocarcinoma. Patients with higher IM SMA CAF/TC SMA CAF ratios were more prone to postoperative recurrence in lung squamous carcinoma.